Exposure of emergency medicine personnel to ionizing radiation during cervical spine radiography.

We studied the potential hazard of ionizing radiation exposure to health care workers who routinely stabilize the necks of trauma patients during cervical spine radiography. A clinical trauma model was developed using an Alderson RANDO Phantom artificial torso to simulate an actual patient. A radiation monitor was placed where a health care worker's fingers, hands, arms, and thyroid gland would be, and standard cervical spine radiographs were taken. The exposures to the finger positions then were repeated with the monitor inside a 0.5 mm lead-equivalent glove. The mean exposure to the finger for a single cross-table lateral radiograph was 174.5 mrem. The use of leaded gloves reduced this exposure to 0.3 mrem a 99.9% reduction). For a single series of lateral, anteroposterior, odontoid, and swimmer's views, the total mean measured unprotected exposure to the finger of the hand positioned nearest the radiographic tube was 681 mrem and the exposure to the finger of the opposite hand was 230 mrem. If these simulated exposures are indicative of actual patient situations, a health care worker who holds the head of a trauma patient four times each week with unshielded hands would receive more than twice the maximum allowable annual occupational radiation exposure to the extremities recommended by the National Council of Radiation Protection and Measurements. We conclude that health care workers who routinely stabilize the necks of trauma patients during cervical spine radiography may incur a radiation exposure risk and that 0.5-mm lead-equivalent gloves provide an effective barrier to ionizing radiation.